26D2175476 CLIA NUMBER - WASHINGTON UNIVERSITY PEDIATRIC SPECIALIST

Laboratory Demographics

  • CLIA Code: 26D2175476
  • Facility Name: WASHINGTON UNIVERSITY PEDIATRIC SPECIALIST
  • Facility Address: 1224 GRAHAM RD, GMC2 SUITE 2010
    FLORISSANT, MO
    ZIP 63031
  • Facility Phone: 314 454-2115
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: CASSANDRA E. PRUITT
  • NPI Number: 1689207870
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 26D2175476
LAB Type Physician Office
Facility Name WASHINGTON UNIVERSITY PEDIATRIC SPECIALIST
Street 1224 GRAHAM RD, GMC2 SUITE 2010
City FLORISSANT
State MO
ZIP 63031
Phone 314 454-2115
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 11/21/2023
Certificate Expiration Date 11/20/2025
Facility Type Physician Office
Lab Director CASSANDRA E. PRUITT

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

This page was last updated on: 9/29/2025